About a third of senior Americans have early signs of the disease (yellow spots called retinal drusen). About 9% of seniors have suffered vision loss from the slowly-progressive “dry” macular degeneration.

About 10% of AMD sufferers eventually develop the fast progressive “wet” form of macular degeneration where there is leakage of fluid and lack of oxygen that triggers invasion by abnormal blood vessels at the back of the eyes that can lead to irreversible legal blindness.

Current treatment for “wet” macular degeneration is effective ~85% of the time and involves direction injection of medicine (Avastin, Lucentis) into the affected eye every 4-6 weeks at a cost of ~$1000 per treatment, plus additional fees for the injection, tests and an office visit. Total cost for AMD drugs now exceeds $2 billion a year just for the drugs.

Up First: Votrient (pazopanib)

Votrient (pazopanib) is a developmental drug that has undergone a successful small trial for AMD that macular degeneration patients will certainly be hearing about.

It is a monoclonal antibody and enzyme (tyrosine kinase) inhibitor. A low oral dose (15 mg) produced improvements in visual acuity and retinal thickness among AMD wet patients, as documented in the Oct. 10 issue of JAMA Ophthalmology.

Votrient is sold as an anti-cancer drug for ~$4.40 per milligram. At this price, a 15 mg oral dose would run about $60/day. At that price, treatment would cost over $21,000 a year. Any proposed savings appear to be imaginary.

Up Second: Lamaplizumab

Another AMD drug is Lampalizumab that has also undergone an early safety and effectiveness trial and may be the first promising drug for the more common dry form of the disease.

In a human trial, monthly 10-miligram doses of Lampalizumab were injected, but improvements were not noted till the sixth month of treatment.

Whether older patients are going to endure repeated needle injections into their eyes without noticeable improvement in their vision is presently unknown. The price of this exotic drug is expected to be similar to Votrient. But imagine the total costs of treating maybe 10 million Medicare patients every month with such an expensive drug that does not improve vision.

Up third: AMD eye drop

A more patient friendly treatment is a therapeutic eye drop. It has only undergone testing in animal eyes, but appears promising. It inhibited the formation of abnormal blood vessels. This eye drop could be used by patients with wet AMD as well as by patients with dry AMD to prevent progression to wet AMD.

A ground breaking report published at the PLoS ONE journal describes this eye drop as pyridoxal phosphate-6-azophenyl-2′, 4′-disulphonic acid (PPADS). It is a derivative of vitamin B6, pyridoxine.

An oral variety of this molecule is pyridoxal phosphate, called PDP, which is readily available as an economical dietary supplement.

PDP is a ready-to-use form of vitamin B6 as it does not require conversion by the liver and is directly transported throughout the body.

Pyridoxal phosphate capsules would provide more system-wide protection for all tissues in the body compared to an eye drop. It is available at health food stores for about $6.00 for a month’s supply (50 mg tablet/20-25 cents/day).

It is obvious here that modern medicine is once again scheming to deliver over-priced medicines at a time when health insurance funds are stretched thin.